Provider Demographics
NPI:1518076751
Name:DRS. FOX, BOYD & SAILER FAMILY DENTISTRY, P.L.C.
Entity Type:Organization
Organization Name:DRS. FOX, BOYD & SAILER FAMILY DENTISTRY, P.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DARRELL
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:712-262-4382
Mailing Address - Street 1:1709 MCNAUGHTON WAY
Mailing Address - Street 2:
Mailing Address - City:SPENCER
Mailing Address - State:IA
Mailing Address - Zip Code:51301-2835
Mailing Address - Country:US
Mailing Address - Phone:712-262-4382
Mailing Address - Fax:712-262-9650
Practice Address - Street 1:1709 MCNAUGHTON WAY
Practice Address - Street 2:
Practice Address - City:SPENCER
Practice Address - State:IA
Practice Address - Zip Code:51301-2835
Practice Address - Country:US
Practice Address - Phone:712-262-4382
Practice Address - Fax:712-262-9650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA67791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0192054Medicaid
IA0194647Medicaid
IA0163188Medicaid
IA0447888Medicaid